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Environmental Health Department <br />SAN JOAQUIN <br />COUNTY <br />Delive LiMitatiOn: <br />Initial if you agree to abide by the following: <br />I understand that I may accept orders and payments via the Internet, mail or phone. However, all lass A" and <br />"Class 13" CFO products must be delivered c_IL- <br />egSly (in person) to the customer. The CFO products may not be <br />delivered via the United States Postal Service, UPS, FedEx, or using any other indirect delivery method as <br />deliveries are regulated by, and subject to, CDPH registration and state and federal requirements. <br />Owner's Statement- <br />-0 U_ 'J <br />/ <br />..i Ifii eriik if e A. iiIi <br />, agree to grant access to the local health department to 4 / • <br />pection of my cottage food operation (mark one) <br />0 "Class B": For regular annual facility inspections <br />and in the event of a consumer complaint or <br />food-borne illness <br />I !A• , /' /-•°0-12(9'6 , agree to notify the San Joaquin County Environmental <br />ealth Depa ment prior to modifying my food list, type of operation, and/or method of selling, distributing, or <br />otherwise providing my CFO products to the consumer or retailers, regardless of whether the product is sold, <br />conduct an in <br />p""Class A": In the event of a consumer <br />complaint or reported food-borne illness <br />consigned, or given away. <br />/ <br />111"7,77 — <br />Owner Signature <br />ffdid -ed. g,rbeAle <br />Date Print ame <br /> <br />2 of 2 <br /> <br />.1'111-172:1=51!&.